Achilles tendon pathology : a role of ultrasonography

Today the Achilles tendinopathies can be diagnosed early by means of sonography, which is non invasive, easy to perform, pratically ubiquitous, economic, precise, repeatable, specific and sensitive. The purpose of this retrospective study was to verify the usefulness of sonography in the diagnosis of Achilles tendinopathies in 158 cases (105 patients). The sonograms revealed 67 cases of tendinosis with peritendinitis, 40 cases of peritendinitis and 30 cases of tendinosis; 21 Achilles tendons with achillodynia had normal sonograms. The results confirm that sonography is a rapid, safe and accurate means of verifying the extension and location of tendinous lesions, as well as the severity of intratendinous degeneration. During the acute phase of inflammatory Achilles tendinopathy, sonography reveals early peritendinous alterations; in chronic forms with intratendinous degeneration, it shows the loss of the normal anatomy of the tendon, which increases in volume, takes on a spindle-like and rounded appearance, and loses its normal oval shape in transversal sections. Sonography also consents to follow the evolution of tendinopathies during treatment, allowing the therapy to be modified in the absence of improvement and providing instrumental confirmation of treatment.